Alice W. Duston

Individual provider Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Cherryfield, ME

NPI 1861531311 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1861531311
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
License
1092870 (ME)
Practice address
63 Main St.
Cherryfield, ME 04622
Phone
(207) 546-2050
Fax
(207) 546-2490
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1092870MEMDIntellectual and/or Developmental Disabilities Residential Treatment Facility

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 1092870 ME Yes

Addresses

Primary practice location

63 Main St.
Cherryfield, ME 04622

Mailing address

PO Box 116
Cherryfield, ME 04622-0116
Phone (207) 546-2050

Other providers in Cherryfield, ME

All providers in Cherryfield, ME · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Maine

Sources for this page

Verify at the official NPI Registry.